Grasping for the Missing Thread: On the (Non)Issue of Systematic Discontinuity in the Treatment of Patients at the End of Life

Ellen Kristvik

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Grasping for the Missing Thread: On the (Non)Issue of Systematic Discontinuity in the Treatment of Patients at the End of Life

于Exploring Issues of Care, Dying and the End of Life

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Ellen Kristvik

Ellen Kristvik
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类型:: 章节

Page Range:: 135–142

DOI:: https://doi.org/10.1163/9781848880580_016

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Continuity of care is a declared goal in many treatment settings, not least for patients in the last stage of life. That real life is often far from this goal is also widely recognised. Discussions about challenges in this respect have often focused on the transition from hospital to primary care. In this presentation, however, I will also include the lack of continuity within the hospital itself. I will draw on material from an ongoing project on user participation in decision-making processes concerning treatment for incurable cancer patients. In this project I have followed patients in the last stage of life, beginning with attending the consultation in which they have received their diagnosis, accompanying them to the oncology department for the administration of chemotherapy, and meeting them in connection with later hospitalisations, when the course of the disease itself or side effects of the treatment have brought them back there. I have also interviewed doctors responsible for their treatment. The distressing impact of the lack of continuity in relation to those responsible for their care and treatment has been a recurring topic in patients’ accounts of their experiences. While presumably agreeing on the desirability of continuity, doctors on their side claim discontinuity to be inevitable in practice. I will argue that this is an organisational chart that reflects a belief in the total replaceability of health care providers, and a focus on ‘health product’ in a situation when attention to ‘treatment process’ would have been more appropriate.

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Exploring Issues of Care, Dying and the End of Life

ISBN:: 9781848880580

出版社:: Brill

印刷出版日期:: 29 Apr 2011

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Grasping for the Missing Thread: On the (Non)Issue of Systematic Discontinuity in the Treatment of Patients at the End of Life

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Exploring Issues of Care, Dying and the End of Life

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